Whatever the case may be, the most efficient overall treatment are those that consist in perception–type therapies, whose aim is to transform the conscious perception of “phantom sounds” into an unconscious one. Thus, Tinnitus Retraining Therapy (TRT) draws on, among other things, a noise generator suggesting an auditory prosthesis and giving off a noise close to the tinnitus. Installed by a specially trained audio prosthetist, it must generally be worn for a period of 12 to 18 months. It is hoped that the patient will become used to the new noise and, indirectly, the noise of the tinnitus which is at a neighboring frequency. The psychological dimension is essential in this treatment. If emotional force is a major factor in the intolerance of the tinnitus given its inextinguishable permanent character, the patient knows in this case that he can “switch off” the sound at any time by disconnecting the noise generator. “In TRT, the psychological intervention of a coach, an audiologist, a psychologist or even a psychiatrist is usual”, indicates Audrey Maudoux. Philippe Lefèbvre adds that a broad approach must be adopted when treating the tinnitus patient.

Another technique which is very popular is self-hypnosis which aims to allow the patient to adjust his sensations, to control them and therefore to push the tinnitus into his unconscious mind. Cognitive behavioral therapies are regularly used to combat chronic tinnitus and are also a valued method. In an entirely different approach, transcranial magnetic stimulation is used in experimental treatments.

One thing is certain: silence is one of the main enemies of the individual suffering from tinnitus. This should be avoided (in isolation, with the help of background music for example), in order to prevent the individual from focusing on parasitical noises. Paying attention to these noises all the time only has the effect of increasing the discomfort caused by them.

Several networks

As we have pointed out, the underlying physiopathological mechanism of tinnitus remains little-known. Recently, researchers at the Cyclotron Research Centre of the University of Liège and the ENT department of the University Hospital of Liège set about recording the cerebral activity of 28 subjects, 13 of whom suffer from unilateral or bilateral tinnitus. This was done by means of Functional Magnetic Resonance Imaging (FMRI) while the subjects were resting that is to say lying down in the scanner without any task to be carried out and allowing their thoughts to wander.

Called “resting-state FMRI”, this technique makes it possible to draw out the “gross” activity of the brain at rest and then to examine the activity of different areas, auditory, attentional, visual... What was the aim of the researchers from Liège? “We wanted to determine what differences in functional connectivity could be found in the auditory network of patients with tinnitus in relation to that of the controlled subjects”, explains Audrey Maudoux.